摘要:

SummaryComputed tomographic scans and magnetic resonance images of 111 normal shoulders of children were reviewed to determine the normal glenoid version in the pediatric age population. Glenoid version varies with age in this population. The glenoid is most retroverted during the first 2 years of life (-6.3±6.5°) and by the end of the first decade of life reaches adult glenoid version (- 1.7±6.4°). The difference between mean glenoid version in early life and mean glenoid version at the end of the first decade of life was statiscally significant (p= 0.0013). Our value determined for adult glenoid version agrees with previous published data in the orthopedic and anthropologic literature. This study provides the normal baseline data for glenoid version in the pediatric age group.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryWe carried out a cross-sectional study to define the prevalence of ulnar nerve instability and its relationship to ligamentous laxity in the pediatric population. Children were divided into three age groups: group I (0-5 years), group II (6-10 years), and group III (11-18 years). Of children in group I 17.7%, of children in group II 7.7%, and 5.7% of children in group III had dislocating ulnar nerves. With the exception of one patient, nerve instability was bilateral. Of those children possessing all five Wynne-Davies signs of ligamentous laxity, 25.4% had dislocating nerves, 71.9% had subluxing nerves, and 2.6% had stable nerves. Age, ulnar nerve instability, and ligamentous laxity were statistically associated (p< 0.0001).

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryFoot progression angle was determined in 400 normal children ranging in age from 4-16 years using a new clinically available assessment technique. Children ages 4-5 were found to have an average out-toeing of 2.8° (1 STD = 6.9°). The average foot progression angle increased with age to 7.3° at age 16 (1 STD = 4.4°). Univariate analysis of these data found that age, tibial alignment, arch index, and the ratio of body weight to body height significantly affected foot progression angle. If, for children 4-16 years of age, two standard deviations from the average of 4.2° out-toeing is taken as a normal range of variance, -8° (in-toeing) to + 16.4° (out-toeing) would be acceptable for these ages. The measurement technique is described in detail, and the normative values and age-specific results are reviewed and discussed.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryDeformities of the wrist and forearm may result from growth disturbance of the radius and ulna. Normal growth patterns were established by measuring the distance between the distal radial and ulnar growth plates in 244 children. The subjects were healthy, well-nourished, middle-class Americans, mostly of Northwest European descent. After the age of 5 years, the distance between the distal radial and distal ulnar growth plates progressively decreased from a mean of 6 mm to a mean of zero by age 13 in girls and age 15 in boys. These measurements are helpful in determining the normal appearance of the wrist during growth and in the early detection of growth discrepancy.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryStress fractures are a common injury in an active population. As children become increasingly involved in organized sports, the recognition of stress fractures and differentiation from infections or neoplasms requires a knowledge of their most common sites, presentation, and clinical course. We retrospectively reviewed 34 stress fractures in 32 skeletally immature patients from June 1977 to May 1993. Age, fracture location, treatment, time to union or healing, associated conditions, complications, radiographs, and clinical outcome were recorded. Fifty percent of patients were involved in sports; the most common complaint was pain with activity. The most common site was the tibia (47%) followed by the fibula (21%) and femur (12%). All had resolution of symptoms and returned to normal activity. All but two healed with either activity modification or cast immobilization. The radiographic findings included early periosteal callus formation that rapidly consolidated to new bone on serial studies. A careful history, physical examination, and radiographs can help diagnose most common stress fractures in the skeletally immature individual and can differentiate stress fractures from infection or neoplasm with appropriate conservative treatment.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryWe reviewed 42 children, aged 1-5 years, with isolated femoral shaft fractures to investigate the possible role of intentional injury in these children. Those children with documented motor vehicle accidents or pathologic fractures were excluded. Follow-up from the Department of Social Services regarding the potential for the fractures being inflicted was obtained. The average age of the children was 3.1±1.2 years; the fracture was spiral in 28, oblique in six, and transverse in eight; history of a fall was present in 34 and absent in eight. The history was considered suspicious for intentional injury in 14 children. In all 42 children, only one fracture was documented to be inflicted; one other child had prior documentation of intentional injury. From this review, the likelihood of intentional injury to the femoral shaft appears to be low; unfortunately, there were no discriminating clinical parameters to help to determine which injuries were intentional. The clinician should continue to have a high index of suspicion and have the circumstances investigated if concern exists regarding the fracture.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThis is a report of three cases of complete dislocation of both the radius and ulna at the elbow in infants born with obstetric palsy. All three patients had painless elbow-flexion contractures. The pathologic anatomy included (a) medial and posterior displacement of the radius and ulna on the humerus, (b) laxity of the lateral capsule and collateral ligaments, (c) contracted medial capsule and collateral ligaments, (d) contracted biceps and triceps muscles, and (e) hypoplasia of the capitellum, trochlea, coronoid process, and olecranon fossa. Open reduction was attempted in all three of these patients and was successful in two.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe purpose of this study was to determine the outcome of patients with a supracondylar fracture and an absent radial pulse. All children with displaced extension-type supracondylar fractures from 1984-1992 were eligible. Of 326 children with supracondylar fractures, 22 had an absent radial pulse on admission. Fifteen of the 22 children had a well-perfused hand after closed reduction and K-wire fixation. Five had no pulse but a well-perfused hand after reduction and immobilization of the elbow in slight flexion; none had any problem at final review. Seven patients who had a cold white hand after closed reduction received open reduction of fracture and arterial exploration. In conclusion, the initial treatment for children with displaced supracondylar fractures with an absent radial pulse should be closed reduction, K-wire fixation, and immobilization in <90° of flexion. Children who have a well-perfused hand but an absent radial pulse after satisfactory closed reduction do not necessarily require routine exploration of the brachial artery.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryCubitus varus may occur after supracondylar humerus fractures. Poor fixation, however, complicates operative treatment of cubitus varus. We discuss the use of external fixation in the treatment of cubitus varus. Five patients had humeral osteotomies with external fixation. The preoperative humeroulnar angle (HUA) averaged -24.2°. The immediate postoperative HUA averaged 12°, and the final angle averaged 13°. Duration of external fixation averaged 8.9 weeks. Complications were one transient radial neurapraxia, one superficial pin infection, and one keloid. No loss of correction or motion occurred with external fixation; we recommend external fixation as safe and effective.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryTo correct angulation and to avoid plaster immobilization in diaphyseal fractures in childhood, intramedullary nailing with flexible titanium pins is an easy and safe method. Under radiographic control, fractures of femur, tibia, and humerus are stabilized with two crossing pins. Forearm fractures are splinted with a single pin each in the radius and the ulna. Even displaced fractures of the radial neck can be corrected with a distally introduced titanium pin. This method is safe in elective trauma surgery and will especially be useful in polytraumatized children in whom multiple fractures should be stabilized with minimal x-ray exposure in a short time.

ISSN:0271-6798    

出版商:OVID    

年代:1996

数据来源: OVID